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Primary care practices need to do more to help protect patients against hepatitis B, a survey commissioned by the British Liver Trust has revealed.

The Trust says practice nurses and GPs are “in the frontline” to protect patients at risk of the cirrhosis and cancer-causing virus, and have a vital role in improving coverage of this vaccine.

But only half of practices claim to follow the Green Book guidelines in vaccinating at-risk patients, according to the survey. Reasons for not offering the vaccine included perceived low risk, time and budget constraints, and patients being unwilling to pay.

The survey also revealed a wide variation in charging practices, with some practices charging patients up to £160 for the vaccine.

Furthermore, a quarter of practices surveyed had waited for patients to admit to high-risk behaviour before offering vaccination

And one in 10 practices did not think it was beneficial to vaccinate injecting drug users.

Alison Rogers, Chief Executive of the British Liver Trust, said: “Practice nurses and GPs are the first line of defence against this potentially fatal virus. They need support to implement the Green Book and well-established clinical guidelines.

“There is also evidence national action is needed. We urge a move to universal immunisation and changes so that GPs offer vaccine free of charge.

“The Trust believes the NHS policy allowing GP practices to charge for vaccination is short-sighted and can only contribute to health inequalities, particularly between different ethnic groups.

“There are enough barriers in place without charging such a huge amount – barriers include stigma of admitting high-risk behaviour, anxiety about vaccine and needing to return for the full course.

“Without action, the cost both to the NHS in treating chronic hepatitis B and its complications is vast and is growing every year. The cost to affected patients and their families is immeasurable.”

The Trust is urging every primary care health professional to be proactive in considering whether a patient is at-risk now or could be in the future.

“We need GPs and practice nurses to offer the vaccine and ensure patients see through the course of three injections with follow-up test for immunity,” said Ms Rogers.